Immediate Implants Do Not Need To Be Long or Large

When the patient returns 4 months post #26 implant 2nd placement, the fractured crowns at #20 and 21 are loose.  The roots are not difficult to remove.  Since the bone height is limited (Fig.1,2), immediate implants are 3.8x8 and 3.8x10 mm, respectively with insertion torque >30 Ncm.  Ball abutments (3.9x2 mm) are placed at #20 and 21; the existing lower RPD is soft relined using #26 1-piecee implant as an abutment.  The retention of the RPD improves.  Another implant will be placed in the lower right quadrant.  One month 10 days postop, the ball abutment at #21 seems to be low (Fig.6).  It is removed after laser gingivectomy and replaced with a ball abutment with 4 mm cuff.  When the patient closes without RPDs, the 1-piece implant at #26 is barely buccal to the upper ridge (Fig.7).  It appears that crowns have to be fabricated at #20,21,26 and 27 prior to refabrication of the lower RPD.

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Xin Wei, DDS, PhD, MS 1st edition 03/10/2018, last revision 04/21/2018